Canfora, Federica (2024) Cognitive Profile in Burning Mouth Syndrome versus Mild Cognitive Impairment: a comparative study. [Tesi di dottorato]

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Abstract

Objectives: This study aims to assess and contrast cognitive and psychological aspects of patients with Burning Mouth Syndrome (BMS) and geriatric patients with Mild Cognitive Impairment (MCI), focusing on potential predictors like pain, mood disorders, blood biomarkers, and Age-Related White Matter Changes (ARWMCs). Materials and Methods: The study enrolled 40 BMS patients with MCI (BMS-MCI) and 40 geriatric MCI patients (G-MCI), matching them by age, gender, and educational background. Participants underwent cognitive testing, mood evaluations, and brain MRIs to identify ARWMCs. The tests included the Mini Mental State Exam (MMSE), Trail Making Test (TMT) parts A and B, Corsi Block-Tapping Task (CB-TT), Rey Auditory Verbal Learning Test (RAVLT), Copying Geometric Drawings Test (CGD), Frontal Assessment Battery (FAB), and Digit Cancellation Test (DCT). Symptoms of depression and anxiety were measured using the Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A), respectively. Other assessments included the 36-Item Short Form Survey (SF-36), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Numeric Rating Scale (NRS), and the short form of the McGill Pain Questionnaire (SF-MPQ). Results: G-MCI patients exhibited higher ARWMCs scores in right (p=0.005**) and left (p<0.001**) temporal regions, which may relate to specific neurodegenerative processes. Conversely, BMS-MCI patients showed higher levels of depression and anxiety and lower cognitive function as measured by the MMSE (p<0.001**), suggesting a more complex interplay between mood disorders and cognitive decline. Notably, BMS-MCI patients struggled more with tasks requiring processing speed and executive function, as evidenced by their higher TMT-A scores (p<0.001**). The influence of educational background, pain levels, cholesterol, sleep disturbances, and anxiety on these cognitive assessments underscores the need for personalized therapeutic strategies addressing both cognitive and emotional aspects of MCI. Conclusions: The study uncovers distinct cognitive and psychological patterns in BMS-MCI compared to G-MCI, highlighting particular deficits in global cognition and processing speed for BMS-MCI. The variation in significant predictors across different cognitive tests suggests that BMS impacts cognitive functions uniquely.

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